title: Patterns of healthcare use among adolescents attending an urban general practitioner-led urgent care centre.
abstract: BACKGROUND
  Adolescence is a time of increasing health and peak fitness, as well as increasing health risks. In the UK, primary care is free at the point of access, yet, adolescents aged 10-19 years are the lowest users of primary care services, and disproportionately high users of emergency services. The effect of new general practitioner (GP)-led urgent care centres in meeting the needs of adolescents are unknown.
  
  
  METHODS
  We used routinely collected data to describe the demographics and attendance pattern among adolescents at two new colocated GP-led urgent care centres at Hammersmith and Charing Cross Hospitals, London. We also compared attendance rates with those observed in routine general practice and emergency departments.
  
  
  RESULTS
  Adolescents formed 6.5% (N=14 038) of total urgent care attendances. 13.2% (95% CI 12.9% to 14.1%) was recorded as not being registered with a GP. Commonest reasons for attendance were musculoskeletal conditions and injuries (30.2%), respiratory tract infections (12.5%) and limb fractures (5.1%). Adolescents aged 15-19 years were more likely to attend the centres (30.6 vs 23.4, per 100, p<0.0001) than routine general practice. The opposite was true for adolescents aged 10-14 years.
  
  
  CONCLUSIONS
  Adolescents aged 15-19 years are more likely to attend urgent care centres than general practice. The majority attended for conditions commonly seen in primary care including musculoskeletal conditions and injuries, and respiratory tract infections. Primary care services may need to be more responsive to needs of the older adolescent age, if their use of urgent care centres is to be reduced.
authors.affiliation: Department of Primary Care and Public Health, Imperial College London, London, UK.
authors.forename: Shamini
authors.initials: S
authors.lastname: Gnani
authors.affiliation: Department of Primary Care and Public Health, Imperial College London, London, UK.
authors.forename: Helen
authors.initials: H
authors.lastname: McDonald
authors.affiliation: Department of Primary Care and Public Health, Imperial College London, London, UK.
authors.forename: Saiful
authors.initials: S
authors.lastname: Islam
authors.affiliation: Department of Primary Care and Public Health, Imperial College London, London, UK.
authors.forename: Farzan
authors.initials: F
authors.lastname: Ramzan
authors.affiliation: North End Medical Centre, London, UK.
authors.forename: Michele
authors.initials: M
authors.lastname: Davison
authors.affiliation: London Central and West Unscheduled Care Collaborative, London, UK.
authors.forename: Tim
authors.initials: T
authors.lastname: Ladbrooke
authors.affiliation: Department of Primary Care and Public Health, Imperial College London, London, UK.
authors.forename: Azeem
authors.initials: A
authors.lastname: Majeed
authors.affiliation: Department of Primary Care and Public Health, Imperial College London, London, UK.
authors.forename: Sonia
authors.initials: S
authors.lastname: Saxena
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D002648:Child; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005194:Family Practice / Q000458:organization & administration*; D005260:Female; D006801:Humans; D008131:London; D008297:Male; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D019037:Urban Health Services / Q000706:statistics & numerical data; D055815:Young Adult
keywords: emergency care systems, primary care; emergency departments; musculo-skeletal; primary care